MEDICARE: MS. DEBRA BERGER LERNER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R050893-1	NY

General Provider Information

NPI Number	:	1932118197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA BERGER LERNER LCSW

Provider Business Mailing Address
First Line	:	1201 DOUGLAS AVE
Second Line	:
City	:	WANTAGH
State	:	NY
Zip	:	11793-1732
Country	:	US
Telephone Number	:	516-643-9295
Fax Number	:

Provider Business Practice Location Address
First Line	:	1918 BELLMORE AVE
Second Line	:	SUITE A
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-5641
Country	:	US
Telephone Number	:	516-643-9295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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